title: Extremely high prevalence of multidrug resistant tuberculosis in Murmansk, Russia: a population-based study.
abstract: Drug resistance and molecular epidemiology of tuberculosis (TB) in the Murmansk region was investigated in a 2-year, population-based surveillance of the civilian population. During 2003 and 2004, isolates from all culture-positive cases were collected (n = 1,226). Prevalence of multi-drug resistance (MDR) was extremely high, as 114 out of 439 new cases (26.0%), and 574 out of 787 previously treated cases (72.9%) were resistant to at least isoniazid (INH) and rifampin (RIF). Spoligotyping of the primary MDR-TB isolates revealed that most isolates grouped to the Beijing SIT1 genotype (n = 91, 79.8%). Isolates of this genotype were further analyzed by IS6110 RFLP. Sequencing of gene targets associated with INH and RIF resistance further showed that the MDR-TB strains are highly homogeneous as 78% of the MDR, SIT1 strains had the same resistance-conferring mutations. The genetic homogeneity of the MDR-TB strains indicates that they are actively transmitted in Murmansk.
authors.affiliation: Antimicrobial Resistance Unit, Mycobacterial Laboratory, National Institute for Health and Welfare, Kiinamyllynkatu 13, 20520 Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Mäkinen
authors.forename: M
authors.initials: M
authors.lastname: Marjamäki
authors.forename: M
authors.initials: M
authors.lastname: Haanperä-Heikkinen
authors.forename: H
authors.initials: H
authors.lastname: Marttila
authors.forename: L B
authors.initials: LB
authors.lastname: Endourova
authors.forename: S E
authors.initials: SE
authors.lastname: Presnova
authors.forename: V
authors.initials: V
authors.lastname: Mathys
authors.forename: P
authors.initials: P
authors.lastname: Bifani
authors.forename: R
authors.initials: R
authors.lastname: Ruohonen
authors.forename: M K
authors.initials: MK
authors.lastname: Viljanen
authors.forename: H
authors.initials: H
authors.lastname: Soini
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology; D005838:Genotype; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D011110:Polymorphism, Genetic; D015995:Prevalence; D012426:Russia / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents